Metachronous Schnitzler’s Metastasis of Gastric Adenocarcinoma 13 Years After Curative Resection: A Case Report

• Published in: The Korean journal of gastroenterology Vol. 84; no. 6; pp. 282 - 287
• Main Authors: Lim, Jun Kyeong, Kim, Suk Bae, Shin, Hyun Deok
• Format: Journal Article
• Language: English
• Published: Korea (South) Jin Publishing & Printing Co 25.12.2024; 대한소화기학회
• Subjects: Adenocarcinoma - diagnosis; Adenocarcinoma - pathology; Adenocarcinoma - secondary; CDX2 Transcription Factor - metabolism; Colonoscopy; Fluorodeoxyglucose F18; Gastrectomy; gastric cancer; Humans; Immunohistochemistry; Keratin-20 - metabolism; Keratin-7 - metabolism; late recurrence; Male; Middle Aged; Positron Emission Tomography Computed Tomography; rectal metastasis; schnitzler’s metastasis; Stomach Neoplasms - diagnosis; Stomach Neoplasms - pathology; subtotal gastrectomy; Tomography, X-Ray Computed; 내과학; Late recurrence; Gastric cancer; Rectal metastasis; Schnitzler’s metastasis; Subtotal gastrectomy
• ISSN: 1598-9992; 2233-6869
• DOI: 10.4166/kjg.2024.091

A 54-year-old man presented with constipation with a six-month duration and a 5 kg weight loss over 10 months. He had undergone a subtotal gastrectomy and chemotherapy for advanced gastric cancer 13 years earlier. A colonoscopy revealed a firm, circular, in-growing mass in the rectum. A computed tomography (CT) scan showed a 3.0×1.2 cm invasive mass near the prostate, abutting the rectal wall and invading the right ureterovesical junction, causing hydroureteronephrosis. A positron emission tomography-CT scan indicated low fluorodeoxyglucose uptake in the rectal or prostate area. The biopsy results showed poorly differentiated carcinoma. An immunohistochemistry study confirmed CK7 positive, CK20 negative, MUC2 negative, and CDX2 focally positive immune phenotype for cancer cells, suggesting a diagnosis of metastatic adenocarcinoma with a gastric origin rather than a prostate and rectal origin.